Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,677.35 / $20,892.96	Facility		$2,818.38	$4,677.35	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,949.84 / $4,677.35	Professional		$1,584.89	$1,949.84	$4,677.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $3,090.30 / $4,570.88	Professional		$2,290.87	$3,090.30	$4,570.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,388.44 / $4,897.79	Facility		$2,344.23	$3,388.44	$4,897.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,388.44 / $4,786.30	Professional		$2,344.23	$3,388.44	$4,786.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,951.21 / $3,715.35	Facility		$2,511.89	$2,951.21	$3,715.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility		$2,089.30	$2,089.30	$2,089.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,467.37 / $4,466.84	Professional		$2,089.30	$3,467.37	$4,466.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,019.95 / $4,073.80	Professional		$2,137.96	$3,019.95	$4,073.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $3,311.31 / $37,153.52	Facility		$1,122.02	$3,311.31	$37,153.52
United Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,754.23 / $4,265.80	Professional		$1,659.59	$2,754.23	$4,265.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,862.09 / $2,630.27	Professional		$1,584.89	$1,862.09	$2,630.27